Wednesday, October 10, 2018

Trump has an opinion

USA Today did choose a picture that made his fist look especially tiny. Photo by Nicholas Kamm/AFP/Getty Images.

In USA Today today, an op-ed by some dude using this silly pseudonym:

Donald Trump: Democrats 'Medicare for All' plan will demolish promises to seniors

The Democrats want to outlaw private health care plans, taking away freedom to choose plans while letting anyone cross our border. We must win this.

I don't know who really wrote it, but that gratuitous lie "while letting anyone cross our border"—if Democrats really did have an open borders policy, which they certainly don't and are not likely to, what relationship would it have to health insurance policy?—is authentically Trumpy, isn't it?

The Medicare for All plan isn't to "outlaw" private health care plans, either, just to eliminate the need for them. I can't imagine, in fact, there wouldn't be some kind of supplementary insurance market, as there are in most countries, whether special coverage for better dentistry or premium hospital rooms or nursing homes, or total opt-out insurance of the kind that covers the wealthiest 10% in UK. Talking about the "freedom to choose plans" is pretty odd coming from anybody who has worked so hard as Republicans have against the choice emphasized in the Affordable Care Act.

The piece is full of lies and misplaced truths, as you'd expect, starting with the allegation that the Medicare for All bill would cost $32.6 trillion over a ten-year period (as it did in one Mercatus Institute forecast) without mentioning that that's replacing some $34 trillion that would be spent otherwise (any reasonable bill is going to cost more than that Mercatus estimate, and cost control measures not in the bill are definitely needed, but the point is that not having a bill costs a comparable amount).

I was especially annoyed by the density of falsehood in one paragraph:
As a candidate, I promised that we would protect coverage for patients with pre-existing conditions and create new health care insurance options that would lower premiums. I have kept that promise, and we are now seeing health insurance premiums coming down.
Those "new health care insurance options" were the return of the old junk policies eliminated by the Affordable Care Act that not only aren't going to be available to people with preexisting conditions but aren't actually going to cover much of anything. Far from protecting those with preexisting conditions, the administration has announced that it won't defend the existing law on that in court against an onslaught by Republican state attorneys general, which is tantamount to inviting the Supreme Court to get rid of it. Health insurance premiums are not coming down; the rate of increase has slowed since the terror of last year, but that's not because of anything Trump has done; it's a result of his and Ryan's and McConnell's failure to overturn the ACA, which has calmed insurers' jittery nerves.

And then there's
The truth is that the centrist Democratic Party is dead. The new Democrats are radical socialists who want to model America’s economy after Venezuela.
Have you got any documentation on that? I hang out in some pretty leftwing circles and I haven't met anybody who wants to model America's economy after Venezuela (except maybe in regard to the classical music education program known as El Sistema, which is a lot older than Chavista socialism in any case).

And so on, and so on, and so on, but there's one issue where Trump's ghostwriter blunders into the truth, and I think that's a problem: the fact that "Medicare for All" doesn't have any Medicare in it, in the sense to which Americans have become accustomed over the past half century:
Throughout the year, we have seen Democrats across the country uniting around a new legislative proposal that would end Medicare as we know it and take away benefits that seniors have paid for their entire lives.
This is one of the things I most don't like about the MfA proposal: if you want to call it Medicare and have it in the United States, it should be "Medicare as we know it", with something related to the 50-year-old structure tied to the premiums taken out of the paycheck. For example one of those buy-in proposals, where people (or better their employers) could (or better could be required to) make an additional contribution to the payroll tax that brings them into the system, and Medicaid funding could be transferred to Medicare to pay for children and the unemployed.

If you want to go with the Sanders proposal you should call it something like "Medicaid for All", which the designers didn't do because that sounded like something for poor people. "Medicare for All" has become amazingly popular in the past year or so, because people think it means what it says, and everybody loves Medicare. The inapposite name leaves the idea open to just the kind of attack Trump's ghostwriter makes on it here, and I'm afraid weeks after the lies are forgotten, that one inadvertent truth is going to keep hanging there.

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